[Giant cystic widening of Virchow-Robin spaces, case report]

Virchow-Robin spaces are very well-known anatomical and radiological entities. However, the observation of giant cystic widening of Virchow-Robin spaces is anecdotic. We report herein the case of a patient presenting with giant cystic widening of Virchow-Robin spaces located in both cerebral hemispheres.

A 26-year-old female presented with numbness of left arm and then, of both arms. CT scan showed many hypodensities located in the two hemispheres. Neurologic examination was normal. MR imaging allowed the diagnosis of giant cystic widening Virchow-Robin spaces in T2, T2*, T1 gadolinium and Flair weighted images. Neuropsychological investigations were normal.

Giant cystic widening of Virchow-Robin spaces are extremely rare entities. MR imaging helps the diagnosis. Only extreme dilatation of Virchow-Robin perivascular spaces close to ventricular system must be watched and treated in case of an obstructive hydrocephalus risk. When located in cerebral hemispheres, these dilatations are mostly asymptomatic and must not be confused with a cystic tumoral disease.